Zambia has pushed back on part of a deal worth more than $1-billion in global health aid from the United States because it does not align with the country’s interests, the government said on Wednesday, as health advocates warned the deal links the money to mining access and has data-sharing risks. 

The deal governs more than $1-billion of US funding to tackle conditions like HIV and malaria, as well as improve disease outbreak preparedness and maternal and child health, over the next five years. It also requires around $340-million in co-financing from the Zambian government over the same period, according to a draft of the agreement reviewed by Reuters.

The deal was due to be signed in November, but had been delayed after revised drafts included a problematic section, a Zambian Ministry of Health spokesperson told Reuters on Wednesday.

That section “did not align with the position and interests of the government of Zambia... We have therefore requested further revisions to the content in question," the spokesperson said, declining to elaborate on what the content covered.

US SUPPORT IN EXCHANGE FOR MINING COLLABORATION

In December, the US said that it had committed, with Zambia, to “a plan that aims to unlock a substantial grant package of US support in exchange for collaboration in the mining sector and clear business sector reforms.”

Zambia is Africa's second-largest copper producer after Democratic Republic of Congo, and also has cobalt, nickel, manganese, graphite, lithium and rare-earth elements.

In response to questions, a US State Department spokesperson told Reuters by email earlier this month that the country would not disclose the details of ongoing diplomatic negotiations. 

“Secretary [of State Marco] Rubio has consistently been clear that foreign assistance is not charity; it is designed to further the national interests of the United States,” they added. The spokesperson did not immediately respond to a request to comment on the status of the deal on Wednesday. 

Zambia said the agreement was focused on health. 

“It has no relation whatsoever to minerals, mining, or any natural resources,” the spokesperson added, saying they remained open to constructive engagement, “but only within terms that are clear, mutually agreed upon, and fully aligned with Zambia’s national interests.”

DRAFT AGREEMENT TIES FUNDING TO COMPACT

However, the draft agreement reviewed by Reuters outlines how the deal will be terminated and funding discontinued if Zambia and the US fail to agree by April 1 on a “bilateral compact” proposed by Rubio to Zambian President Hakainde Hichilema on November 17, 2025. Three sources said that compact was tied to mining collaboration.

Health advocates in both countries said the data-sharing agreement in the draft, which was due to last for 10 years, was also problematic, and raised concerns over the secrecy surrounding the negotiations. 

“The data sharing will be one way from Zambia to the US and the information will benefit the US,” said Owen Mulenga, an officer at the Treatment, Advocacy and Literacy Campaign, a local non-governmental organisation lobbying for equitable, affordable and sustainable access to treatment, care and support for people living with HIV and AIDS in Zambia. 

“We need support from the US but there should be transparency,” Mulenga told Reuters. He said there was a lot of speculation the deal was tied to mining but the government had declined to talk about this with activists. 

“This deal would slash US government funding to life-saving programs… while prioritising the interests of mining corporations over the needs of Zambians with HIV,” said Asia Russell, executive director of Health GAP, a global HIV advocacy organisation that has closely followed the deal.

The deal is the latest in a series of bilateral agreements reshaping how President Trump’s administration delivers billions of dollars in global health funding, after dismantling its aid agency last year, cutting funding and contracts worldwide - including in Zambia - and pledging to put “America First” in its global health strategy.

Earlier on Wednesday, Zimbabwe pulled out of a deal worth $367-million, citing data sharing and privacy concerns and describing it as unequal. Kenya’s more than $1.6-billion deal with the US is also suspended, pending a legal case. However, several other countries – including Nigeria and Uganda – have signed.